WHAT IS A 'LEGAL THEORY' OF YOUR DISABILITY CASE?

The simplest definition of a "legal theory" that I can think of is this:

It is the legal justification for paying a disability benefit under the Social Security Act and related federal laws.

If I looked at as disability case and made a list of 5 rules or regulations that permits Social Security to pay my client a benefit, I have a legal theory of the case.

You might also look at a legal theory as a roadmap to get the claim paid.  

It could be thought of as a checklist:  Here are the things the law requires, and here is how the claimant meets all of those requirements.

Claims are denied because decision makers do not believe that all of the regulations have been met.  If they can be convinced that all the rules have been met, then the claim will get paid.

I often see claimants take the approach that "I am a good, honest person who tells the truth.  I have always worked hard and now I really need this disability benefit.  I want Social Security to believe me and pay me."

This is not a legal argument.  It is usually true, but it isn't enough to get the government to pay a benefit.  Here is the approach the government wants to see:

1.  Prove that you are covered under the Social Security Act and have insured status.

2.  Use objective medical evidence to prove your residual functional capacity.  In other words, prove what is the highest level of functioning you are able to sustain.

3.  Show that you meet all of the rules and regulations of the Social Security Administration to qualify for a disability benefit.

So, the winning approach is more technical, more legal in nature.  Are you disabled (1) because you meet a Listing, (2) by a medical-vocational guideline, (3) or by proving that you cannot perform at least unskilled sedentary work?

Unless you can show that you fall into one of those categories, you cannot be approved.  

Therefore, before you get close to your hearing, you need to have your legal theory of the case worked out in detail.  For most folks, this will involve appointing a disability attorney or advocate to map out the strategy to win.

Social Security Justice in Huntsville